Medical Surgical Exam Four questions
and answers
Modifiable Risk Factors of Stroke - ANSWER>>Hypertension
Diabetes
Hyperlipidemia (low cholesterol diet & increase fiber)
Smoking
Obesity
Stress
Diet (bad-high fat, processed) & Exercise
Non-Modifiable Risk Factors of Stroke - ANSWER>>Age (55+)
Gender (Male)
Race (African American & Hispanic)
Family History/Genetics
Stroke Nursing Assessment - ANSWER>>CT Scan- Rapid! (25 min) (check renal function)
Neuro Assessment
Balance & Coordination
Speech
Hemiplegia & Hemiparesis Definitions - ANSWER>>Hemiplegia (half of body paralyzed)
Hemiparesis (half of body weakness)
Dysarthria & Apraxia Definitions - ANSWER>>Dysarthria (slurred speech)
Apraxia (substitutes wrong words)
Dysphasia & Dysphagia - ANSWER>>Dysphasia (difficulty speaking)
Dysphagia (difficulty swallowing)
Aphasia: Expressive vs. Receptive - ANSWER>>Aphasia: difficulty communicating
Expressive: Cannot ANSWER, knows ANSWER but cannot get it out
Receptive: Do not understand what you are saying
Global: Both
, Loss of Proprioception - ANSWER>>Loss of proprioception: ability to perceive the position of
your body in space
Ischemic Stroke Symptoms - ANSWER>>Hemiplegia
Hemiparesis
Dysarthria
Apraxia
Dysphasia
Dysphagia
Aphasia: difficulty communicating
Expressive: Cannot ANSWER, knows ANSWER but cannot get it out
Receptive: Do not understand what you are saying
Global: Both
Loss of proprioception: ability to perceive the position of your body in space
Facial Droop
Hemorrhagic Stroke Nursing Assessment - ANSWER>>CT
MRI to determine extent of damage
Under 40- Drug Screen
No Lumbar Puncture
Aneurysm Precautions: bed rest laying down, dim lights, SCD (leg squeezers), need them to turn
still, stool softeners
Environment: Quiet, head of bed 30 degrees
Bowel/Bladder
Lighting
Prevention
Bed Rest
Sedation
If INR high, use Vitamin K and plasma
Hemorrhagic Pharmacological Treatment - ANSWER>>If caused by elevated INR due to
Warfarin
Reverse INR with FFP and Vitamin K
If caused by NOACs: Idarucizumab (Praxbind) reverses dabigatran (Pradaxa)
Seizures: phenytoin (Dilantin) (more likely for seizures)
Anti-hypertensives (ACE favored)
Analgesics for pain
Acetaminophen for fever
and answers
Modifiable Risk Factors of Stroke - ANSWER>>Hypertension
Diabetes
Hyperlipidemia (low cholesterol diet & increase fiber)
Smoking
Obesity
Stress
Diet (bad-high fat, processed) & Exercise
Non-Modifiable Risk Factors of Stroke - ANSWER>>Age (55+)
Gender (Male)
Race (African American & Hispanic)
Family History/Genetics
Stroke Nursing Assessment - ANSWER>>CT Scan- Rapid! (25 min) (check renal function)
Neuro Assessment
Balance & Coordination
Speech
Hemiplegia & Hemiparesis Definitions - ANSWER>>Hemiplegia (half of body paralyzed)
Hemiparesis (half of body weakness)
Dysarthria & Apraxia Definitions - ANSWER>>Dysarthria (slurred speech)
Apraxia (substitutes wrong words)
Dysphasia & Dysphagia - ANSWER>>Dysphasia (difficulty speaking)
Dysphagia (difficulty swallowing)
Aphasia: Expressive vs. Receptive - ANSWER>>Aphasia: difficulty communicating
Expressive: Cannot ANSWER, knows ANSWER but cannot get it out
Receptive: Do not understand what you are saying
Global: Both
, Loss of Proprioception - ANSWER>>Loss of proprioception: ability to perceive the position of
your body in space
Ischemic Stroke Symptoms - ANSWER>>Hemiplegia
Hemiparesis
Dysarthria
Apraxia
Dysphasia
Dysphagia
Aphasia: difficulty communicating
Expressive: Cannot ANSWER, knows ANSWER but cannot get it out
Receptive: Do not understand what you are saying
Global: Both
Loss of proprioception: ability to perceive the position of your body in space
Facial Droop
Hemorrhagic Stroke Nursing Assessment - ANSWER>>CT
MRI to determine extent of damage
Under 40- Drug Screen
No Lumbar Puncture
Aneurysm Precautions: bed rest laying down, dim lights, SCD (leg squeezers), need them to turn
still, stool softeners
Environment: Quiet, head of bed 30 degrees
Bowel/Bladder
Lighting
Prevention
Bed Rest
Sedation
If INR high, use Vitamin K and plasma
Hemorrhagic Pharmacological Treatment - ANSWER>>If caused by elevated INR due to
Warfarin
Reverse INR with FFP and Vitamin K
If caused by NOACs: Idarucizumab (Praxbind) reverses dabigatran (Pradaxa)
Seizures: phenytoin (Dilantin) (more likely for seizures)
Anti-hypertensives (ACE favored)
Analgesics for pain
Acetaminophen for fever
